A recent op-ed piece appearing in the Sunday New York Times (“In Therapy Forever? Enough Already”) has touched a nerve with quite a number of therapists. It’s not hard to see why. The author of the piece argues that long-term therapy is often “ineffective” and those who practice it are little more than passive head-nodders, who simply answer questions with more questions. Such criticisms of therapy are nothing new, but generally those doing the criticizing are not themselves therapists.
According to The New York Times, Mr. Alpert is a “New York psychotherapist” and author of a soon to be released self-help book entitled Be Fearless: Change Your Life in 28 Days. It is this latter factoid that helps to explain Mr. Alpert’s glib and reductionistic approach to therapy. I’m not surprised that a man who proudly refers to himself as “Manhattan’s most media-friendly psychotherapist” could be so self-promoting. What really disappoints me, however, is that The New York Times allowed their editorial page to be exploited to promote Mr. Alpert's book.
Although I take serious issue with Mr. Alpert’s portrayal of long-term psychotherapy, these types of therapy-bashing articles can sometimes serve to open up wider discussions about psychotherapy and how it actually works. Few in our field would argue with Mr. Alpert’s claim that there are mental disorders that can be effectively treated with certain forms of short-term, solution-focussed therapy. Where I and other psychodynamically oriented therapists take issue with Mr. Alpert is his unfounded conclusion that longer forms of therapy are somehow “ineffective” and unwarranted. Mr. Alpert cites several studies to support this claim, but he conveniently ignores just as many published peer-reviewed studies that show many patients, particularly those with severe and chronic mental health conditions, make more lasting improvements with long-term intensive treatments than other forms of briefer treatment. One such meta-analysis written by Dr. Jonathan Shedler and published in the The American Psychologist, concluded that “the effect sizes for psychodynamic therapies are “as large as those reported for other treatments...” and that the evidence indicates that the “benefits of psychodynamic treatment are lasting and not just transitory and appear to extend well beyond symptom remission.”
By omitting such findings, Mr. Alpert does a disservice to the profession and to the thousands of patients each year who benefit from long-term psychodynamic psychotherapy.
Tyger Latham, Psy.D. is a licensed clinical psychologist practicing in Washington, DC. He counsels individuals and couples and has a particular interest in sexual trauma, gender development, and LGBT concerns. His blog, Therapy Matters, explores the art and science of psychotherapy.